TREATMENT OF SEVERE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN HOSPITAL SETTING

Abstract

The main goal of treating chronic obstructive disease (COPD) is the prevention of acute and serious exacerbations, that is, the timely application of effective therapy when an exacerbation occurs. As a nonpharmacological strategy for the treatment of acute exacerbations of COPD associated with acute respiratory insufficiency, the importance of applying respiratory support in the form of oxygen therapy and non-invasive ventilation is emphasized. The goal of the work: Analysis of patient characteristics, length of hospitalization, type of respiratory support and outcome of treatment. Material and methods: This retrospective study included a group of 408 patients who, in the period from January 1, 2022. until December 31, 2022. were treated in the Clinic for Pulmonary Diseases of the University Hospital of the Republic of Srpska, due to an acute exacerbation of COPD associated with acute respiratory insufficiency. The necessary parameters (age, sex, diagnosis of COPD, length of hospitalization, comorbidities) were taken from the medical records of each individual patient and were processed using methods from the domain of descriptive statistics. Results: Out of the total number of 408 patients, 266 (65.2%) were male and 142 (38.8%) were female. A total of 358 patients have at least one significant comorbidity associated with them, which is relatively 87.75% of all patients with severe exacerbation of COPD. The average age of the mentioned patients is 70 years, while the average duration of hospitalization was 8.87 days. A total of 370 patients (90.68%) were discharged from the Clinic for Pulmonary Diseases cured, while 38 patients (9.32%) ended with a fatal outcome. Out of 408, 304 patients (74.5%) were treated only with oxygen therapy, while 104 patients (25.5%) required intermittent use of non-invasive ventilation. Patients who required the application of non-invasive ventilation survived the exacerbation in 83.65% of cases and were discharged home, while 16.35% of patients ended fatally. Conclusion: Timely and adequate application of oxygen therapy and non-invasive ventilation leads to improvement of gas exchange, reduces work of breathing and the need for intubation, and reduces mortality and length of hospitalization